Predicting unplanned hospital visits in older home care recipients: a cross-country external validation study

Abstract Background Accurate identification of older persons at risk of unplanned hospital visits can facilitate preventive interventions. Several risk scores have been developed to identify older adults at risk of unplanned hospital visits. It is unclear whether risk scores developed in one country, perform as well in another. This study validates seven risk scores to predict unplanned hospital admissions and emergency department (ED) visits in older home care recipients from six countries. Methods We used the IBenC sample (n = 2446), a cohort of older home care recipients from six countries (Belgium, Finland, Germany, Iceland, Italy and The Netherlands) to validate four specific risk scores (DIVERT, CARS, EARLI and previous acute admissions) and three frailty indicators (CHESS, Fried Frailty Criteria and Frailty Index). Outcome measures were unplanned hospital admissions, ED visits or any unplanned hospital visits after 6 months. Missing data were handled by multiple imputation. Performance was determined by assessing calibration and discrimination (area under receiver operating characteristic curve (AUC)). Results Risk score performance varied across countries. In Iceland, for any unplanned hospital visits DIVERT and CARS reached a fair predictive value (AUC 0.74 [0.68–0.80] and AUC 0.74 [0.67–0.80]), respectively). In Finland, DIVERT had fair performance predicting ED visits (AUC 0.72 [0.67–0.77]) and any unplanned hospital visits (AUC 0.73 [0.67–0.77]). In other countries, AUCs did not exceed 0.70. Conclusions Geographical validation of risk scores predicting unplanned hospital visits in home care recipients showed substantial variations of poor to fair performance across countries. Unplanned hospital visits seem considerably dependent on healthcare context. Therefore, risk scores should be validated regionally before applied to practice. Future studies should focus on identification of more discriminative predictors in order to develop more accurate risk scores. Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Jet H. Klunder [verfasserIn] Veronique Bordonis [verfasserIn] Martijn W. Heymans [verfasserIn] Henriëtte G. van der Roest [verfasserIn] Anja Declercq [verfasserIn] Jan H. Smit [verfasserIn] Vjenka Garms-Homolova [verfasserIn] Pálmi V. Jónsson [verfasserIn] Harriet Finne-Soveri [verfasserIn] Graziano Onder [verfasserIn] Karlijn J. Joling [verfasserIn] Otto R. Maarsingh [verfasserIn] Hein P. J. van Hout [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2021

Schlagwörter:	Risk prediction models Unplanned hospitalizations Emergency department visits Geographical validation Home care

Übergeordnetes Werk:	In: BMC Geriatrics - BMC, 2003, 21(2021), 1, Seite 9
Übergeordnetes Werk:	volume:21 ; year:2021 ; number:1 ; pages:9

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc

DOI / URN:	10.1186/s12877-021-02521-2

Katalog-ID:	DOAJ072199342

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520			\|a Abstract Background Accurate identification of older persons at risk of unplanned hospital visits can facilitate preventive interventions. Several risk scores have been developed to identify older adults at risk of unplanned hospital visits. It is unclear whether risk scores developed in one country, perform as well in another. This study validates seven risk scores to predict unplanned hospital admissions and emergency department (ED) visits in older home care recipients from six countries. Methods We used the IBenC sample (n = 2446), a cohort of older home care recipients from six countries (Belgium, Finland, Germany, Iceland, Italy and The Netherlands) to validate four specific risk scores (DIVERT, CARS, EARLI and previous acute admissions) and three frailty indicators (CHESS, Fried Frailty Criteria and Frailty Index). Outcome measures were unplanned hospital admissions, ED visits or any unplanned hospital visits after 6 months. Missing data were handled by multiple imputation. Performance was determined by assessing calibration and discrimination (area under receiver operating characteristic curve (AUC)). Results Risk score performance varied across countries. In Iceland, for any unplanned hospital visits DIVERT and CARS reached a fair predictive value (AUC 0.74 [0.68–0.80] and AUC 0.74 [0.67–0.80]), respectively). In Finland, DIVERT had fair performance predicting ED visits (AUC 0.72 [0.67–0.77]) and any unplanned hospital visits (AUC 0.73 [0.67–0.77]). In other countries, AUCs did not exceed 0.70. Conclusions Geographical validation of risk scores predicting unplanned hospital visits in home care recipients showed substantial variations of poor to fair performance across countries. Unplanned hospital visits seem considerably dependent on healthcare context. Therefore, risk scores should be validated regionally before applied to practice. Future studies should focus on identification of more discriminative predictors in order to develop more accurate risk scores.
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allfields	10.1186/s12877-021-02521-2 doi (DE-627)DOAJ072199342 (DE-599)DOAJ253e45fe6a1b45b8804c38aed4e1e31e DE-627 ger DE-627 rakwb eng RC952-954.6 Jet H. Klunder verfasserin aut Predicting unplanned hospital visits in older home care recipients: a cross-country external validation study 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background Accurate identification of older persons at risk of unplanned hospital visits can facilitate preventive interventions. Several risk scores have been developed to identify older adults at risk of unplanned hospital visits. It is unclear whether risk scores developed in one country, perform as well in another. This study validates seven risk scores to predict unplanned hospital admissions and emergency department (ED) visits in older home care recipients from six countries. Methods We used the IBenC sample (n = 2446), a cohort of older home care recipients from six countries (Belgium, Finland, Germany, Iceland, Italy and The Netherlands) to validate four specific risk scores (DIVERT, CARS, EARLI and previous acute admissions) and three frailty indicators (CHESS, Fried Frailty Criteria and Frailty Index). Outcome measures were unplanned hospital admissions, ED visits or any unplanned hospital visits after 6 months. Missing data were handled by multiple imputation. Performance was determined by assessing calibration and discrimination (area under receiver operating characteristic curve (AUC)). Results Risk score performance varied across countries. In Iceland, for any unplanned hospital visits DIVERT and CARS reached a fair predictive value (AUC 0.74 [0.68–0.80] and AUC 0.74 [0.67–0.80]), respectively). In Finland, DIVERT had fair performance predicting ED visits (AUC 0.72 [0.67–0.77]) and any unplanned hospital visits (AUC 0.73 [0.67–0.77]). In other countries, AUCs did not exceed 0.70. Conclusions Geographical validation of risk scores predicting unplanned hospital visits in home care recipients showed substantial variations of poor to fair performance across countries. Unplanned hospital visits seem considerably dependent on healthcare context. Therefore, risk scores should be validated regionally before applied to practice. Future studies should focus on identification of more discriminative predictors in order to develop more accurate risk scores. Risk prediction models Unplanned hospitalizations Emergency department visits Geographical validation Home care Geriatrics Veronique Bordonis verfasserin aut Martijn W. Heymans verfasserin aut Henriëtte G. van der Roest verfasserin aut Anja Declercq verfasserin aut Jan H. Smit verfasserin aut Vjenka Garms-Homolova verfasserin aut Pálmi V. Jónsson verfasserin aut Harriet Finne-Soveri verfasserin aut Graziano Onder verfasserin aut Karlijn J. Joling verfasserin aut Otto R. Maarsingh verfasserin aut Hein P. J. van Hout verfasserin aut In BMC Geriatrics BMC, 2003 21(2021), 1, Seite 9 (DE-627)335488994 (DE-600)2059865-8 14712318 nnns volume:21 year:2021 number:1 pages:9 https://doi.org/10.1186/s12877-021-02521-2 kostenfrei https://doaj.org/article/253e45fe6a1b45b8804c38aed4e1e31e kostenfrei https://doi.org/10.1186/s12877-021-02521-2 kostenfrei https://doaj.org/toc/1471-2318 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_375 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 21 2021 1 9
spelling	10.1186/s12877-021-02521-2 doi (DE-627)DOAJ072199342 (DE-599)DOAJ253e45fe6a1b45b8804c38aed4e1e31e DE-627 ger DE-627 rakwb eng RC952-954.6 Jet H. Klunder verfasserin aut Predicting unplanned hospital visits in older home care recipients: a cross-country external validation study 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background Accurate identification of older persons at risk of unplanned hospital visits can facilitate preventive interventions. Several risk scores have been developed to identify older adults at risk of unplanned hospital visits. It is unclear whether risk scores developed in one country, perform as well in another. This study validates seven risk scores to predict unplanned hospital admissions and emergency department (ED) visits in older home care recipients from six countries. Methods We used the IBenC sample (n = 2446), a cohort of older home care recipients from six countries (Belgium, Finland, Germany, Iceland, Italy and The Netherlands) to validate four specific risk scores (DIVERT, CARS, EARLI and previous acute admissions) and three frailty indicators (CHESS, Fried Frailty Criteria and Frailty Index). Outcome measures were unplanned hospital admissions, ED visits or any unplanned hospital visits after 6 months. Missing data were handled by multiple imputation. Performance was determined by assessing calibration and discrimination (area under receiver operating characteristic curve (AUC)). Results Risk score performance varied across countries. In Iceland, for any unplanned hospital visits DIVERT and CARS reached a fair predictive value (AUC 0.74 [0.68–0.80] and AUC 0.74 [0.67–0.80]), respectively). In Finland, DIVERT had fair performance predicting ED visits (AUC 0.72 [0.67–0.77]) and any unplanned hospital visits (AUC 0.73 [0.67–0.77]). In other countries, AUCs did not exceed 0.70. Conclusions Geographical validation of risk scores predicting unplanned hospital visits in home care recipients showed substantial variations of poor to fair performance across countries. Unplanned hospital visits seem considerably dependent on healthcare context. Therefore, risk scores should be validated regionally before applied to practice. Future studies should focus on identification of more discriminative predictors in order to develop more accurate risk scores. Risk prediction models Unplanned hospitalizations Emergency department visits Geographical validation Home care Geriatrics Veronique Bordonis verfasserin aut Martijn W. Heymans verfasserin aut Henriëtte G. van der Roest verfasserin aut Anja Declercq verfasserin aut Jan H. Smit verfasserin aut Vjenka Garms-Homolova verfasserin aut Pálmi V. Jónsson verfasserin aut Harriet Finne-Soveri verfasserin aut Graziano Onder verfasserin aut Karlijn J. Joling verfasserin aut Otto R. Maarsingh verfasserin aut Hein P. J. van Hout verfasserin aut In BMC Geriatrics BMC, 2003 21(2021), 1, Seite 9 (DE-627)335488994 (DE-600)2059865-8 14712318 nnns volume:21 year:2021 number:1 pages:9 https://doi.org/10.1186/s12877-021-02521-2 kostenfrei https://doaj.org/article/253e45fe6a1b45b8804c38aed4e1e31e kostenfrei https://doi.org/10.1186/s12877-021-02521-2 kostenfrei https://doaj.org/toc/1471-2318 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_375 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 21 2021 1 9
allfields_unstemmed	10.1186/s12877-021-02521-2 doi (DE-627)DOAJ072199342 (DE-599)DOAJ253e45fe6a1b45b8804c38aed4e1e31e DE-627 ger DE-627 rakwb eng RC952-954.6 Jet H. Klunder verfasserin aut Predicting unplanned hospital visits in older home care recipients: a cross-country external validation study 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background Accurate identification of older persons at risk of unplanned hospital visits can facilitate preventive interventions. Several risk scores have been developed to identify older adults at risk of unplanned hospital visits. It is unclear whether risk scores developed in one country, perform as well in another. This study validates seven risk scores to predict unplanned hospital admissions and emergency department (ED) visits in older home care recipients from six countries. Methods We used the IBenC sample (n = 2446), a cohort of older home care recipients from six countries (Belgium, Finland, Germany, Iceland, Italy and The Netherlands) to validate four specific risk scores (DIVERT, CARS, EARLI and previous acute admissions) and three frailty indicators (CHESS, Fried Frailty Criteria and Frailty Index). Outcome measures were unplanned hospital admissions, ED visits or any unplanned hospital visits after 6 months. Missing data were handled by multiple imputation. Performance was determined by assessing calibration and discrimination (area under receiver operating characteristic curve (AUC)). Results Risk score performance varied across countries. In Iceland, for any unplanned hospital visits DIVERT and CARS reached a fair predictive value (AUC 0.74 [0.68–0.80] and AUC 0.74 [0.67–0.80]), respectively). In Finland, DIVERT had fair performance predicting ED visits (AUC 0.72 [0.67–0.77]) and any unplanned hospital visits (AUC 0.73 [0.67–0.77]). In other countries, AUCs did not exceed 0.70. Conclusions Geographical validation of risk scores predicting unplanned hospital visits in home care recipients showed substantial variations of poor to fair performance across countries. Unplanned hospital visits seem considerably dependent on healthcare context. Therefore, risk scores should be validated regionally before applied to practice. Future studies should focus on identification of more discriminative predictors in order to develop more accurate risk scores. Risk prediction models Unplanned hospitalizations Emergency department visits Geographical validation Home care Geriatrics Veronique Bordonis verfasserin aut Martijn W. Heymans verfasserin aut Henriëtte G. van der Roest verfasserin aut Anja Declercq verfasserin aut Jan H. Smit verfasserin aut Vjenka Garms-Homolova verfasserin aut Pálmi V. Jónsson verfasserin aut Harriet Finne-Soveri verfasserin aut Graziano Onder verfasserin aut Karlijn J. Joling verfasserin aut Otto R. Maarsingh verfasserin aut Hein P. J. van Hout verfasserin aut In BMC Geriatrics BMC, 2003 21(2021), 1, Seite 9 (DE-627)335488994 (DE-600)2059865-8 14712318 nnns volume:21 year:2021 number:1 pages:9 https://doi.org/10.1186/s12877-021-02521-2 kostenfrei https://doaj.org/article/253e45fe6a1b45b8804c38aed4e1e31e kostenfrei https://doi.org/10.1186/s12877-021-02521-2 kostenfrei https://doaj.org/toc/1471-2318 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_375 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 21 2021 1 9
allfieldsGer	10.1186/s12877-021-02521-2 doi (DE-627)DOAJ072199342 (DE-599)DOAJ253e45fe6a1b45b8804c38aed4e1e31e DE-627 ger DE-627 rakwb eng RC952-954.6 Jet H. Klunder verfasserin aut Predicting unplanned hospital visits in older home care recipients: a cross-country external validation study 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background Accurate identification of older persons at risk of unplanned hospital visits can facilitate preventive interventions. Several risk scores have been developed to identify older adults at risk of unplanned hospital visits. It is unclear whether risk scores developed in one country, perform as well in another. This study validates seven risk scores to predict unplanned hospital admissions and emergency department (ED) visits in older home care recipients from six countries. Methods We used the IBenC sample (n = 2446), a cohort of older home care recipients from six countries (Belgium, Finland, Germany, Iceland, Italy and The Netherlands) to validate four specific risk scores (DIVERT, CARS, EARLI and previous acute admissions) and three frailty indicators (CHESS, Fried Frailty Criteria and Frailty Index). Outcome measures were unplanned hospital admissions, ED visits or any unplanned hospital visits after 6 months. Missing data were handled by multiple imputation. Performance was determined by assessing calibration and discrimination (area under receiver operating characteristic curve (AUC)). Results Risk score performance varied across countries. In Iceland, for any unplanned hospital visits DIVERT and CARS reached a fair predictive value (AUC 0.74 [0.68–0.80] and AUC 0.74 [0.67–0.80]), respectively). In Finland, DIVERT had fair performance predicting ED visits (AUC 0.72 [0.67–0.77]) and any unplanned hospital visits (AUC 0.73 [0.67–0.77]). In other countries, AUCs did not exceed 0.70. Conclusions Geographical validation of risk scores predicting unplanned hospital visits in home care recipients showed substantial variations of poor to fair performance across countries. Unplanned hospital visits seem considerably dependent on healthcare context. Therefore, risk scores should be validated regionally before applied to practice. Future studies should focus on identification of more discriminative predictors in order to develop more accurate risk scores. Risk prediction models Unplanned hospitalizations Emergency department visits Geographical validation Home care Geriatrics Veronique Bordonis verfasserin aut Martijn W. Heymans verfasserin aut Henriëtte G. van der Roest verfasserin aut Anja Declercq verfasserin aut Jan H. Smit verfasserin aut Vjenka Garms-Homolova verfasserin aut Pálmi V. Jónsson verfasserin aut Harriet Finne-Soveri verfasserin aut Graziano Onder verfasserin aut Karlijn J. Joling verfasserin aut Otto R. Maarsingh verfasserin aut Hein P. J. van Hout verfasserin aut In BMC Geriatrics BMC, 2003 21(2021), 1, Seite 9 (DE-627)335488994 (DE-600)2059865-8 14712318 nnns volume:21 year:2021 number:1 pages:9 https://doi.org/10.1186/s12877-021-02521-2 kostenfrei https://doaj.org/article/253e45fe6a1b45b8804c38aed4e1e31e kostenfrei https://doi.org/10.1186/s12877-021-02521-2 kostenfrei https://doaj.org/toc/1471-2318 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_375 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 21 2021 1 9
allfieldsSound	10.1186/s12877-021-02521-2 doi (DE-627)DOAJ072199342 (DE-599)DOAJ253e45fe6a1b45b8804c38aed4e1e31e DE-627 ger DE-627 rakwb eng RC952-954.6 Jet H. Klunder verfasserin aut Predicting unplanned hospital visits in older home care recipients: a cross-country external validation study 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background Accurate identification of older persons at risk of unplanned hospital visits can facilitate preventive interventions. Several risk scores have been developed to identify older adults at risk of unplanned hospital visits. It is unclear whether risk scores developed in one country, perform as well in another. This study validates seven risk scores to predict unplanned hospital admissions and emergency department (ED) visits in older home care recipients from six countries. Methods We used the IBenC sample (n = 2446), a cohort of older home care recipients from six countries (Belgium, Finland, Germany, Iceland, Italy and The Netherlands) to validate four specific risk scores (DIVERT, CARS, EARLI and previous acute admissions) and three frailty indicators (CHESS, Fried Frailty Criteria and Frailty Index). Outcome measures were unplanned hospital admissions, ED visits or any unplanned hospital visits after 6 months. Missing data were handled by multiple imputation. Performance was determined by assessing calibration and discrimination (area under receiver operating characteristic curve (AUC)). Results Risk score performance varied across countries. In Iceland, for any unplanned hospital visits DIVERT and CARS reached a fair predictive value (AUC 0.74 [0.68–0.80] and AUC 0.74 [0.67–0.80]), respectively). In Finland, DIVERT had fair performance predicting ED visits (AUC 0.72 [0.67–0.77]) and any unplanned hospital visits (AUC 0.73 [0.67–0.77]). In other countries, AUCs did not exceed 0.70. Conclusions Geographical validation of risk scores predicting unplanned hospital visits in home care recipients showed substantial variations of poor to fair performance across countries. Unplanned hospital visits seem considerably dependent on healthcare context. Therefore, risk scores should be validated regionally before applied to practice. Future studies should focus on identification of more discriminative predictors in order to develop more accurate risk scores. Risk prediction models Unplanned hospitalizations Emergency department visits Geographical validation Home care Geriatrics Veronique Bordonis verfasserin aut Martijn W. Heymans verfasserin aut Henriëtte G. van der Roest verfasserin aut Anja Declercq verfasserin aut Jan H. Smit verfasserin aut Vjenka Garms-Homolova verfasserin aut Pálmi V. Jónsson verfasserin aut Harriet Finne-Soveri verfasserin aut Graziano Onder verfasserin aut Karlijn J. Joling verfasserin aut Otto R. Maarsingh verfasserin aut Hein P. J. van Hout verfasserin aut In BMC Geriatrics BMC, 2003 21(2021), 1, Seite 9 (DE-627)335488994 (DE-600)2059865-8 14712318 nnns volume:21 year:2021 number:1 pages:9 https://doi.org/10.1186/s12877-021-02521-2 kostenfrei https://doaj.org/article/253e45fe6a1b45b8804c38aed4e1e31e kostenfrei https://doi.org/10.1186/s12877-021-02521-2 kostenfrei https://doaj.org/toc/1471-2318 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_375 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 21 2021 1 9
language	English
source	In BMC Geriatrics 21(2021), 1, Seite 9 volume:21 year:2021 number:1 pages:9
sourceStr	In BMC Geriatrics 21(2021), 1, Seite 9 volume:21 year:2021 number:1 pages:9
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Risk prediction models Unplanned hospitalizations Emergency department visits Geographical validation Home care Geriatrics
isfreeaccess_bool	true
container_title	BMC Geriatrics
authorswithroles_txt_mv	Jet H. Klunder @@aut@@ Veronique Bordonis @@aut@@ Martijn W. Heymans @@aut@@ Henriëtte G. van der Roest @@aut@@ Anja Declercq @@aut@@ Jan H. Smit @@aut@@ Vjenka Garms-Homolova @@aut@@ Pálmi V. Jónsson @@aut@@ Harriet Finne-Soveri @@aut@@ Graziano Onder @@aut@@ Karlijn J. Joling @@aut@@ Otto R. Maarsingh @@aut@@ Hein P. J. van Hout @@aut@@
publishDateDaySort_date	2021-01-01T00:00:00Z
hierarchy_top_id	335488994
id	DOAJ072199342
language_de	englisch
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Klunder</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Predicting unplanned hospital visits in older home care recipients: a cross-country external validation study</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2021</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">Text</subfield><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Abstract Background Accurate identification of older persons at risk of unplanned hospital visits can facilitate preventive interventions. Several risk scores have been developed to identify older adults at risk of unplanned hospital visits. It is unclear whether risk scores developed in one country, perform as well in another. This study validates seven risk scores to predict unplanned hospital admissions and emergency department (ED) visits in older home care recipients from six countries. Methods We used the IBenC sample (n = 2446), a cohort of older home care recipients from six countries (Belgium, Finland, Germany, Iceland, Italy and The Netherlands) to validate four specific risk scores (DIVERT, CARS, EARLI and previous acute admissions) and three frailty indicators (CHESS, Fried Frailty Criteria and Frailty Index). Outcome measures were unplanned hospital admissions, ED visits or any unplanned hospital visits after 6 months. Missing data were handled by multiple imputation. Performance was determined by assessing calibration and discrimination (area under receiver operating characteristic curve (AUC)). Results Risk score performance varied across countries. In Iceland, for any unplanned hospital visits DIVERT and CARS reached a fair predictive value (AUC 0.74 [0.68–0.80] and AUC 0.74 [0.67–0.80]), respectively). In Finland, DIVERT had fair performance predicting ED visits (AUC 0.72 [0.67–0.77]) and any unplanned hospital visits (AUC 0.73 [0.67–0.77]). In other countries, AUCs did not exceed 0.70. Conclusions Geographical validation of risk scores predicting unplanned hospital visits in home care recipients showed substantial variations of poor to fair performance across countries. Unplanned hospital visits seem considerably dependent on healthcare context. Therefore, risk scores should be validated regionally before applied to practice. 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callnumber-first	R - Medicine
author	Jet H. Klunder
spellingShingle	Jet H. Klunder misc RC952-954.6 misc Risk prediction models misc Unplanned hospitalizations misc Emergency department visits misc Geographical validation misc Home care misc Geriatrics Predicting unplanned hospital visits in older home care recipients: a cross-country external validation study
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topic_title	RC952-954.6 Predicting unplanned hospital visits in older home care recipients: a cross-country external validation study Risk prediction models Unplanned hospitalizations Emergency department visits Geographical validation Home care
topic	misc RC952-954.6 misc Risk prediction models misc Unplanned hospitalizations misc Emergency department visits misc Geographical validation misc Home care misc Geriatrics
topic_unstemmed	misc RC952-954.6 misc Risk prediction models misc Unplanned hospitalizations misc Emergency department visits misc Geographical validation misc Home care misc Geriatrics
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title	Predicting unplanned hospital visits in older home care recipients: a cross-country external validation study
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title_full	Predicting unplanned hospital visits in older home care recipients: a cross-country external validation study
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author_browse	Jet H. Klunder Veronique Bordonis Martijn W. Heymans Henriëtte G. van der Roest Anja Declercq Jan H. Smit Vjenka Garms-Homolova Pálmi V. Jónsson Harriet Finne-Soveri Graziano Onder Karlijn J. Joling Otto R. Maarsingh Hein P. J. van Hout
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title_sort	predicting unplanned hospital visits in older home care recipients: a cross-country external validation study
callnumber	RC952-954.6
title_auth	Predicting unplanned hospital visits in older home care recipients: a cross-country external validation study
abstract	Abstract Background Accurate identification of older persons at risk of unplanned hospital visits can facilitate preventive interventions. Several risk scores have been developed to identify older adults at risk of unplanned hospital visits. It is unclear whether risk scores developed in one country, perform as well in another. This study validates seven risk scores to predict unplanned hospital admissions and emergency department (ED) visits in older home care recipients from six countries. Methods We used the IBenC sample (n = 2446), a cohort of older home care recipients from six countries (Belgium, Finland, Germany, Iceland, Italy and The Netherlands) to validate four specific risk scores (DIVERT, CARS, EARLI and previous acute admissions) and three frailty indicators (CHESS, Fried Frailty Criteria and Frailty Index). Outcome measures were unplanned hospital admissions, ED visits or any unplanned hospital visits after 6 months. Missing data were handled by multiple imputation. Performance was determined by assessing calibration and discrimination (area under receiver operating characteristic curve (AUC)). Results Risk score performance varied across countries. In Iceland, for any unplanned hospital visits DIVERT and CARS reached a fair predictive value (AUC 0.74 [0.68–0.80] and AUC 0.74 [0.67–0.80]), respectively). In Finland, DIVERT had fair performance predicting ED visits (AUC 0.72 [0.67–0.77]) and any unplanned hospital visits (AUC 0.73 [0.67–0.77]). In other countries, AUCs did not exceed 0.70. Conclusions Geographical validation of risk scores predicting unplanned hospital visits in home care recipients showed substantial variations of poor to fair performance across countries. Unplanned hospital visits seem considerably dependent on healthcare context. Therefore, risk scores should be validated regionally before applied to practice. Future studies should focus on identification of more discriminative predictors in order to develop more accurate risk scores.
abstractGer	Abstract Background Accurate identification of older persons at risk of unplanned hospital visits can facilitate preventive interventions. Several risk scores have been developed to identify older adults at risk of unplanned hospital visits. It is unclear whether risk scores developed in one country, perform as well in another. This study validates seven risk scores to predict unplanned hospital admissions and emergency department (ED) visits in older home care recipients from six countries. Methods We used the IBenC sample (n = 2446), a cohort of older home care recipients from six countries (Belgium, Finland, Germany, Iceland, Italy and The Netherlands) to validate four specific risk scores (DIVERT, CARS, EARLI and previous acute admissions) and three frailty indicators (CHESS, Fried Frailty Criteria and Frailty Index). Outcome measures were unplanned hospital admissions, ED visits or any unplanned hospital visits after 6 months. Missing data were handled by multiple imputation. Performance was determined by assessing calibration and discrimination (area under receiver operating characteristic curve (AUC)). Results Risk score performance varied across countries. In Iceland, for any unplanned hospital visits DIVERT and CARS reached a fair predictive value (AUC 0.74 [0.68–0.80] and AUC 0.74 [0.67–0.80]), respectively). In Finland, DIVERT had fair performance predicting ED visits (AUC 0.72 [0.67–0.77]) and any unplanned hospital visits (AUC 0.73 [0.67–0.77]). In other countries, AUCs did not exceed 0.70. Conclusions Geographical validation of risk scores predicting unplanned hospital visits in home care recipients showed substantial variations of poor to fair performance across countries. Unplanned hospital visits seem considerably dependent on healthcare context. Therefore, risk scores should be validated regionally before applied to practice. Future studies should focus on identification of more discriminative predictors in order to develop more accurate risk scores.
abstract_unstemmed	Abstract Background Accurate identification of older persons at risk of unplanned hospital visits can facilitate preventive interventions. Several risk scores have been developed to identify older adults at risk of unplanned hospital visits. It is unclear whether risk scores developed in one country, perform as well in another. This study validates seven risk scores to predict unplanned hospital admissions and emergency department (ED) visits in older home care recipients from six countries. Methods We used the IBenC sample (n = 2446), a cohort of older home care recipients from six countries (Belgium, Finland, Germany, Iceland, Italy and The Netherlands) to validate four specific risk scores (DIVERT, CARS, EARLI and previous acute admissions) and three frailty indicators (CHESS, Fried Frailty Criteria and Frailty Index). Outcome measures were unplanned hospital admissions, ED visits or any unplanned hospital visits after 6 months. Missing data were handled by multiple imputation. Performance was determined by assessing calibration and discrimination (area under receiver operating characteristic curve (AUC)). Results Risk score performance varied across countries. In Iceland, for any unplanned hospital visits DIVERT and CARS reached a fair predictive value (AUC 0.74 [0.68–0.80] and AUC 0.74 [0.67–0.80]), respectively). In Finland, DIVERT had fair performance predicting ED visits (AUC 0.72 [0.67–0.77]) and any unplanned hospital visits (AUC 0.73 [0.67–0.77]). In other countries, AUCs did not exceed 0.70. Conclusions Geographical validation of risk scores predicting unplanned hospital visits in home care recipients showed substantial variations of poor to fair performance across countries. Unplanned hospital visits seem considerably dependent on healthcare context. Therefore, risk scores should be validated regionally before applied to practice. Future studies should focus on identification of more discriminative predictors in order to develop more accurate risk scores.
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title_short	Predicting unplanned hospital visits in older home care recipients: a cross-country external validation study
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author2	Veronique Bordonis Martijn W. Heymans Henriëtte G. van der Roest Anja Declercq Jan H. Smit Vjenka Garms-Homolova Pálmi V. Jónsson Harriet Finne-Soveri Graziano Onder Karlijn J. Joling Otto R. Maarsingh Hein P. J. van Hout
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Predicting unplanned hospital visits in older home care recipients: a cross-country external validation study

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